Physical and psychological safety should be key focuses for CNOs.
With rising workplace violence and burnout rates, it's important for CNOs and other nurse leaders to be aware of the safety and wellbeing of their nurses.
Safety goes beyond just the physical. Nurses must feel psychologically safe as well—they should be able to voice their feelings and concerns without fear.
During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Jennifer Croland, vice president and chief nursing officer at OSF HealthCare Saint Francis Medical Center, and Dr. Marie Giordano-Mulligan, vice president for nursing and chief nursing officer at Huntington Hospital Northwell Health, both spoke about how CNOs can help their nurses feel physically and psychologically safe at work.
Workplace violence prevention
There are several investments that health systems can make toward workplace violence prevention. According to Giordano-Mulligan, at Huntington Hospital Northwell Health, they have technology that boosts security, including quick badge alerts, metal detectors, and drones that fly around the campus, which remains well-lit at all hours.
Giordano-Mulligan also said they have signage that displays how respect from patients, family, and visitors is a requirement, and that the hospital does not tolerate violence toward the nursing staff or other healthcare workers.
"[For] any patient that is considered a high risk, we do have enhanced safety measures, and there [are] workplace violence processes in place," Giordano-Mulligan said, "and the staff is very appreciative knowing that they are supported in those processes."
Support is also provided to nurses after incidents occur, in the form of both employee assistance programs and employee health services if injuries are sustained.
"They're also given the option to file a police report as well and press charges," Giordano-Mulligan said, "and we will support them in that because they have that right."
In terms of mental health and psychological safety, Giordano-Mulligan said Huntington Hospital has processes in place for helping nurses improve wellbeing.
"If they need support for any other concerns…there is a process in place to help them with employee support services," Giordano-Mulligan said, "and there's a committee that is very active working with…executive leadership and with team inputs to enhance those processes in the future."
Psychological safety
Burnout is a huge contributing factor to mental health in the workplace, and according to Croland, one of the subgroups that has the highest degree of burnout is nurses who have under three years of experience.
"I've seen lots more people who are only working for a year and then they're choosing to leave the nursing profession," Croland said.
CNOs are also concerned with the public perception of nursing, and how that contributes to participation in the industry and potentially the culture of a health system.
"If you're on social media at all, you've probably seen the TikTok [videos] that are disparaging to the profession," Croland said, "so we have some accountability, I think, in changing that image of nursing."
Croland recommends implementing more transition to practice programs that go beyond orientation and onboarding. Nurses need to develop a sense of belonging in their units and learn the necessary communication skills.
"How do you work in a culture where you can respectfully escalate a concern to another nurse who's working, who may be shutting you down?" Croland said, "and I think transition to practice programs are gaining a lot more traction."
The ANCC has criteria for transition to practice programs that Croland recommended. The criteria exist to help nurses acclimatize better to the profession and become more equipped to deal with the stressors that accompany the job.
"When you think about what we do, it requires high reliability, really high stakes outcomes, [it's] life and death, and that's a lot to put on a young person who's new in their role," Croland said.
CNOs must create environments where nurses can come forward and admit that they are not sure whether they did something right or wrong, or that they made a mistake that affected the patient.
"I think those programs are worth their weight in gold," Croland said, "they have demonstrated successes with reducing turnover, increasing retention, and really keeping people within the profession of nursing."
At a time when nurse leader turnover is stressing the industry, CNOs from all over the country are gathering together to strategize solutions.
The nursing industry is currently facing some of the largest workforce challenges in healthcare, including a nationwide nursing shortage and record numbers of burnout and turnover. Now more than ever, nurse leaders need to come together to address major issues to keep health systems running effectively while improving patient outcomes.
That’s why HealthLeaders has high hopes for the AONL Annual Conference in New Orleans, Louisiana next week, where thousands of nurse leaders will gather to discuss these trends in the nursing industry.
What we will be watching
The conference consists of daily sessions where various nurse leaders will highlight industry trends and provide their insight. One of the biggest topics is technological innovation, and how nurse executives can leverage AI, robotics, and virtual care to promote workforce growth, and improve productivity and patient outcomes.
Another big trend is leadership development, and how to turn nurse managers into effective leaders who set examples in the workplace. Recruitment and retention are also a central theme of the sessions, focusing on how leaders can build safe and healthy work environments where nurses want to work—even for nurse leaders.
The conference comes at a time when high turnover rates among nurse leaders present a real workforce challenge. A recent report found that 31% of nurse leaders said they plan to be in a different role a year from now.
Will AONL attendees come up with the solution to the issue? Probably not, but HealthLeaders will be there to take note of what is and isn’t working.
Other themes include fostering academic partnerships, creating educational opportunities, developing care models, and the importance of mental health care. Attendees will have the opportunity to attend these sessions as well as walk through the exhibit hall.
Stay tuned for more coverage of the event and what you will need to know.
CNOs must stay vigilant and help their nurses avoid burnout.
Burnout is being cited across the industry as one of the top workforce challenges. So, what can CNO’s do about it?
During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Jennifer Croland, vice president and chief nursing officer at OSF HealthCare Saint Francis Medical Center, and Dr. Marie Giordano-Mulligan, vice president for nursing and chief nursing officer at Huntington Hospital Northwell Health, both spoke at length about how CNOs can reduce burnout among their workforces.
Nurses in different generations have different needs that CNOs must fairly accomodate.
On this week’s episode of HL Shorts, we hear from Cassie Lewis, Chief Nursing Officer for the Richmond market at Bon Secours Mercy Health, about how CNOs can ensure that offerings are equitable between generations of nurses. Tune in to hear her insights.
Nurses everywhere are feeling the effects of burnout, and so are nurse leaders.
Burnout is being cited across the industry as one of the top workforce challenges. A report from AMN Healthcare found that 72% of nurse leaders experience some level of burnout.
So, what can CNO’s do about it?
During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Jennifer Croland, vice president and chief nursing officer at OSF HealthCare Saint Francis Medical Center, and Dr. Marie Giordano-Mulligan, vice president for nursing and chief nursing officer at Huntington Hospital Northwell Health, both spoke at length about how CNOs can reduce burnout among their workforces.
Identifying the problem
Croland compared burnout to “death by paper cuts.”
“Everybody has bad days,” Croland said, “but it’s when it’s happening all the time and we’re not able to recover from it that I think that analogy comes to mind.”
The first step in addressing burnout is to identify when nurses are experiencing more than just a bad day. If nurses are returning to work the next day and are back to normal, that is likely just exhaustion, whereas burnout presents a more consistent personality shift.
“[It’s] the person who’s no longer engaged, the person who doesn’t participate, or their personality has changed,” Giordano-Mulligan said, “even with collaboration with their peers, they just don’t seem to be the same.”
When a nurse begins to feel this way, it’s important for CNOs and other nurse leaders to intervene and help that individual. Giordano-Mulligan emphasized that outside stressors are a large contributing factor as well. World events and family obligations can bring additional stress into the workplace.
“We have programs that come in to help reduce all of these stresses for employees,” Giordano-Mulligan said. “We have to help these individuals to feel comfortable coming to us so that we can help them with employee support services.”
Along with programs, having a personal connection with each member of a nurse unit is also critical for identifying burnout. Croland explained how that connection and relationship is necessary to be able to notice a change happening.
“Recognizing when there are subtle differences, whether they’re angry or more withdrawn,” Croland said, “those are going to be indicators that something’s going on.”
According to Croland, making sure employees are utilizing resources available to them is also key to preventing burnout. Nurses should have sick or wellbeing days, and CNOs must make sure that they are using them. If nurses are financially struggling, leaders should sit down with them and connect them to employee assistance programs or a financial counselor, or another resource offered by the health system or hospital.
“Sometimes the burnout isn’t necessarily caused by something that’s happening at work, but it’s being exacerbated by something in their home life,” Croland said. “We have the opportunity to connect them through to resources that could help them.”
Strategic solutions
One of the best ways to address and prevent burnout is having personal relationships with staff, and according to Croland, being intentional and having thoughtful conversations with them. At OSF St. Francis, they do monthly mission partner rounding.
“So very intentional, purposeful rounding that the leaders are doing with their frontline staff asking them [questions],” Croland said, “what’s going well, what frustrated [them] in the last couple shifts [they] worked…what problems have you experienced, [and] how can I help?”
Croland recommended making the effort to understand the nuances and pain points that nurses have, and to work to address each of those things, since burnout is often caused by the build up of those little stressors.
Additionally, Croland suggested putting more focus on having micro debriefings at the bedside, to help nurses deal with the frequent whiplash of handling one tough patient situation and then moving on to the next.
“We don’t often times give ourselves as the clinicians the opportunity to process what happened, [or] the opportunity to talk things through,” Croland said. “[It’s important] if you’re a newer nurse, [to take] the time to get the assurances that you did a good job and that you did what you were supposed to, to have that support.”
Giordano-Mulligan agreed, citing her focus on creating healthy work environments and authentic leadership in her career. CNOs need to build relationships with their staff so that when something is going on, the nurse is comfortable confiding in the CNO, and they know they have a safe place to go.
“Getting to know your staff and [having that] relationship building is extremely important,” Giordano-Mulligan said, “and to know when a team member is not who they normally are.”
At Huntington Hospital Northwell Health, Giordano-Mulligan said the hospital has a process called Team Lavendar to help nurses deal with patient losses.
“There’s a team that comes in and helps support the staff and [the other] people involved in that loss,” Giordano-Mulligan said, “to give them the time to decompress, [or] to go off to the tranquility space, and to have the time to come back…[and] go on the next assignment.”
The program also allows nurses to be relieved, so that they can come back to their next shift with the right frame of mind.
“Part of being able to care for others is to care for self,” Giordano-Mulligan said, “because if you’re not in that space to be in a good frame of health or mind, you can’t begin to care for others appropriately.”
Compensation and benefits packages need to evolve with the workforce.
Compensation is not the only factor that nurses consider when choosing a health system. Benefits packages, workplace culture, safety, and flexibility all play a role in the decision-making process.
Here are five tips for compensation and benefits that CNOs need to know, according to Robin Steaban, Chief Nursing Officer at Vanderbilt University Hospital.
People will not stay in a culture where they feel unsafe, says this CNO.
On this week’s episode of HL Shorts, we hear from Robin Steaban, Chief Nursing Officer at Vanderbilt University Hospital, about what nurses value in workplace culture, and how culture can be treated as a benefit. Tune in to hear her insights.
Nurses are considering more than just compensation, says this CNO.
Compensation is not the only factor that nurses consider when choosing a health system. Benefits packages, workplace culture, safety, and flexibility all play a role in the decision-making process.
CNOs should take a look at their health system’s offerings to make sure they are attractive to new nurses and that they are staying competitive in the industry.
During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Robin Steaban, Chief Nursing Officer at Vanderbilt University Hospital, spoke about innovative perks to attract and keep nurses, and how workplace culture and safety play a role as benefits alongside compensation.
Diversifying offerings
First and foremost, health systems need to stay market competitive with both compensation and benefits packages. According to Steaban, that is the minimum a health system can do, along with making sure that employees are fully aware of all of the offered benefits.
“Today’s workforce is so much different than it has been historically,” Steaban said. “So diversifying what’s available for your employees is really important.”
It is crucial that CNOs understand the different needs and desires of their staff. Steaban explained that many nurses who are entering the workforce for the first time do not need healthcare coverage because they are still covered by their parents.
“So how do you create programs that are a little bit diverse for them so that they can still achieve some benefit?” Steaban said.
Flexibility is also a huge need in today’s workforce, and Steaban suggested creating some positions in a health system with associated compensation that offer various degrees of flexibility. This could include an internal travel resource pool where nurses can have more options, or even for working in different hospitals within the health system. The key is to diversify the work and match compensation to it.
There are some newer benefits that health systems should consider offering, including wellness benefits, loan forgiveness, tuition assistance, and compensation for certification or advancement programs.
“All of those things help people change their compensation level and benefits in multiple ways [during] employment,” Steaban said, “versus just straight compensation.”
Culture as a benefit
Workplace culture plays a large role in nurse retention and overall satisfaction. A strong workplace culture will make nurses feel less alone and more like a part of a team, enabling them to ask questions without being judged.
“Every day I run into nurses, and I ask [them] what keeps them here,” Steaban said, “and nine times out of ten they say [their] team.”
Steaban emphasized that people will not stay in a work environment where they do not feel safe or where they cannot practice safely. Because of that, the relationships nurses have with physicians and other technicians are also extremely important.
Nurses also need to have a voice and feel heard and responded to. CNOs should provide opportunities to influence their health system, and they should help nurses be successful, advance their careers, and have the experiences that want to have at work.
“There should be forums and places where nurses can really impact the direction of the organization and the standards of care,” Steaban said, “[so they can] really put their fingerprints on their own work life.”
According to Steaban, CNOs should remember that health systems are businesses with the goal of helping patients, and that change must happen, or the business will fail. Nurses should be included in that change, and change management is a vital part of that.
“At the front line of the care continuum are those nurses,” Steaban said, “if they understand why, and they can put their fingerprints on the process a bit, they’ll appreciate that.”
Presenting culture
CNOs need to show the culture of their health system to potential candidates so they can see the benefits of working there. According to Steaban, this starts with demonstrating on first contact with a new nurse that the health system is not only interested in the work being done, but about the candidate as a person. Candidates should also be connected with the team they would be working with, so they can get an idea of what the culture is in that unit.
“Words are cheap,” Steaban said. “The actual experience of the culture is what will either glue them to you or not.”
Nurse leaders should manage the culture across their organizations and make sure that everyone is walking the walk, not just talking the talk, Steaban explained.
“Make sure that your culture is not just on a sheet of paper, or words of a mission or vision,” Steaban said, “but it’s actually the truth of what people experience when they start working.”
Flexibility
As more nurses are looking for flexibility as a benefit, health systems should evaluate where they can put programs into place to accommodate their nurses’ needs. At Vanderbilt University Hospital, Steaban says they are working on a way for nurses to contribute and describe what flexibility they need, since it is different for everyone.
For nurses going back to school, weekend programs can be beneficial, so that nurses can attend classes Monday through Friday and then work on the weekends. Likewise, for nurses with young children, mid shift assignments are helpful if they need to drop off and pick up their kids from school at the correct time while still being able to work.
Steaban says they also have a robust PRN program, where nurses are able to choose the days they want to work and they can fill in where the organization has needs and have ultimate flexibility over their schedules.
“Self-scheduling is still something we do debate all the time, [and] whether it sometimes can create a lot of stress for nurses,” Steaban said. “You actually get to pick your shifts and you can [give] yourself some time off by putting your shifts [in] early in the schedule or late in the schedule.”
There are also travel program options or short-term programs where a nurse can decide if they want to work frequently for a short period of time and then take extended periods off, so they can craft their life like they want.
“That’s really hard to do on a unit,” Steaban said, “but you can do it as an organization, [and] say we’re going to use those nurses to fill in where we have some gaps, but they’ll work a 13-week contract or 6-week contract.”
However, CNOs should still be weighing the nurses’ flexibility with the quality of patient care, according to Steaban. Nurses need to be spending enough time with their patients to develop relationships with them and fulfill care obligations.
“What’s hard for me is our ultimate responsibility is to our patients,” Steaban said. “If your nurse is changing every two or four hours, I worry about our clinical obligation to patients.”
Career advancement
Nurses are also looking for career advancement opportunities as a benefit. At Vanderbilt, Steaban said they have a career advancement program for staff nurses, with peer mentors who can help walk them through the program.
Steaban also recommends offering certification courses as a way to help nurses specialize in their practice. Continuing education credits are also important for nurses to make sure they meet the criteria for certifications and so that they can uphold standards of care.
“Offering certification courses, offering to pay for [them], [and] paying for the completion of that certification testing [are] all really important,” Steaban said, “and then aligning compensation with those accomplishments.”
Geisinger's CNE discusses their health system's goals for virtual nursing.
CNOs everywhere are talking about virtual nursing, and many predict that virtual nursing will help fill the gaps from the nursing shortage.
Janet Tomcavage, executive vice president and chief nurse executive at Geisinger, outlined what Geisinger wants to accomplish with their virtual nursing model. Tomcavage is a part of the HealthLeaders Virtual Nursing Mastermind panel, a months-long, exclusive series where several health systems will discuss the ins and outs of their virtual nursing programs and what their goals are for implementing these new technologies.
Here are Geisinger's four goals for their virtual nursing program.
The HealthLeaders Mastermind series is an exclusive, months-long series of calls and an in-person event featuring hand-selected healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights on exceling your virtual nursing program. Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Geisinger's CNE discusses their health system's goals for virtual nursing.
CNOs everywhere are talking about virtual nursing. Health systems across the country are utilizing their nurses and technology departments to create new programs that have the potential to revolutionize the industry.
Virtual nursing provides new opportunities for nurses to have more flexibility, and for hospitals to use their staff more efficiently. A single nurse can now observe more patients at once, and watch for signs of patient discomfort or distress. Tenured nurses can stay employed longer, without having to worry about working long shifts, and they can support new nurses virtually.
Additionally, many CNOs predict that virtual nursing will help fill the gaps from the nursing shortage, and many health systems have already seen positive results from their programs.
Janet Tomcavage, executive vice president and chief nurse executive at Geisinger, outlined what Geisinger wants to accomplish with their virtual nursing model.
Tomcavage is a part of the HealthLeaders Virtual Nursing Mastermind series, an exclusive, six-month series of calls and an in-person event where several health systems discuss the ins and outs of their virtual nursing programs.
Geisinger's goals
Geisinger is one of many health systems to embark on the virtual nursing journey, and according to Tomcavage, they are most excited to be fully leveraging technology for the first time as a way to support care. There are several goals that Geisinger has already begun to accomplish with their virtual nursing program.
The first has to do with the nursing shortage, which Tomcavage said everyone is aware of. While there are many things that need to be done to solve the workforce issue, virtual nursing is a key component that can help make a big impact.
"We think of it in terms of really opening up the workforce by creating… a new role for nurses to consider, especially later in their career," Tomcavage said, "those who maybe have left, now have options to come back."
The next area of focus at Geisinger is on care quality. According to Tomcavage, the acuity of patients in the hospital is much higher than it has been in the past, due to both the COVID-19 pandemic and other factors. That along with lower tenure of the nursing staff has created several challenges.
"I think the virtual model can really help us enhance quality and things like fall prevention, hospital acquired pressure injuries…mentoring new graduate nurses…[and] patient education" Tomcavage said.
Another key goal is employee engagement, and how virtual nursing can help their nurses directly. Tomcavage explained how the response to the virtual nursing program has been overwhelmingly positive.
"Once [the nurses] really got a handle on what virtual nursing could do, they've been extremely positive about it," Tomcavage said.
The final area that Geisinger is focusing on is patient engagement and experience. According to Tomcavage, there was some apprehension about what the patient response to the virtual nurses would be, but patients have been enthusiastic.
"The virtual model gives patients that one-on-one time with nurses that's uninterrupted," Tomcavage said, "and you can get through an assessment and not miss anything."
The HealthLeaders Mastermind seriesis an exclusive series of calls and events with healthcare executives. This Virtual NursingMastermind series features ideas, solutions, and insights onexceling your virtual nursing program.Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.